Mesothelioma Treatment

The most common mesothelioma treatments are surgery, chemotherapy, and radiation. These treatments can help patients live longer and with less pain. Some patients also access newer treatments through clinical trials. Veterans with mesothelioma can find the best treatments and doctors through the U.S. Department of Veterans Affairs (VA).

What is Mesothelioma Video Thumbnail

Video Summary: Registered Nurse Amy Fair explains what mesothelioma is, the causes, and the symptoms.

What is Mesothelioma?

Mesothelioma attacks the tissues that line most major organs, called the mesothelium. It is known mainly to attack the mesothelium of the lung, pericardial sack, peritoneal cavity in the abdomen, and also known to attack the lining of the testicles.

One of the first symptoms for developing mesothelioma is shortness of breath. A lot of times folks will have the shortness of breath with the pleuritic chest pain. This is also followed sometimes by substantial weight loss.

Many times after being diagnosed with mesothelioma your physician may ask you if you have been exposed to asbestos. Asbestos is a causative factor for mesothelioma. Some of the imaging studies may show underlying pleural plaques which are indicated that they have been around asbestos and may have underlying asbestosis.

The risk factors for developing mesothelioma are working around asbestos-related products, or being indirectly around those products such as secondhand exposures that are seen with wives that launder their loves ones' clothes that have asbestos dust on them. So direct asbestos exposure, as well as indirect asbestos exposure, can be causative factors for mesothelioma.

If you have symptoms of mesothelioma of any asbestos-related disease, it’s important that you inform your doctor of your asbestos exposure so that appropriate testing can be done.

Medically edited and fact-checked by: Todd Gersten, MDDouble Board-Certified Oncologist and Hematologist
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How Is Mesothelioma Treated?

Patients can access different treatments for mesothelioma based on factors like the location of tumors, their general health, and cancer spread.

Mesothelioma treatments are used to:

  • Destroy, shrink, and remove cancer tumors
  • Help patients live longer
  • Reduce painful mesothelioma symptoms

Your doctor will help you create the best treatment plan for your goals and needs. Without treatment, this cancer can quickly be fatal.

An older man sits with a male doctor

Mesothelioma Surgery

Mesothelioma surgery is often considered the best treatment option. Doctors can remove cancer tumors from the body with several types of surgery.

Mesothelioma chemotherapy drugs shrink tumors. Chemotherapy is typically given in cycles so patients can recover from any side effects.

Mesothelioma radiation uses high-energy X-rays to kill cancer cells. Radiation also causes the tumors to shrink, making them easier to remove with surgery.

Immunotherapy is a newer type of mesothelioma treatment. It helps the body to find and destroy mesothelioma cells.

TTFs slow the growth of cancer tumors by using electrically charged pads that stick to the skin. The electricity prevents cancer cells from dividing.

Multimodal treatment combines therapies. For example, doctors may remove tumors with surgery and then use radiation or chemotherapy to kill leftover cancer cells.

Pleural Mesothelioma Treatment

Malignant pleural mesothelioma forms in the lining of the lungs (pleura). It’s the most common form of mesothelioma and makes up 80-85% of all cases, so many treatments exist.

Surgeries for Pleural Mesothelioma

Surgery is most often used for patients with early-stage pleural mesothelioma as the cancer hasn’t spread to distant areas of the body.

Two main surgery options are extrapleural pneumonectomy (EPP) or pleurectomy with decortication (P/D).

Extrapleural Pneumonectomy (EPP)

With an extrapleural pneumonectomy, doctors remove the lung closest to the cancerous tumors, the lining of the lungs (pleura), the lining of the heart (pericardium), and parts of the diaphragm.

Patients must be in good overall health to qualify for this surgical procedure as it is very aggressive. Patients may also face quality of life issues afterward. For example, they may need to rely on an oxygen tank.

Diagram explaining an extrapleural pneumonectomy (EPP). Doctors remove the lung closest to the cancer, along with the heart lining, part of the diaphragm, and all visible cancer tumors.Diagram explaining an extrapleural pneumonectomy (EPP). Doctors remove the lung closest to the cancer, along with the heart lining, part of the diaphragm, and all visible cancer tumors.

Pleurectomy With Decortication (P/D)

A pleurectomy with decortication removes cancerous tissue from the lining of the heart, the lung lining, and the diaphragm. The lung itself is not removed.

Many oncologists (cancer doctors) prefer the P/D because it is less intensive and spares the affected lung unlike the EPP, which removes the entire lung. Additionally, the P/D offers many of the same benefits as the EPP.

Diagram explaining a pleurectomy with decortication (P/D). Doctors remove the lung lining and cancer tumors. Neither lung is removed in this surgery. Diagram explaining a pleurectomy with decortication (P/D). Doctors remove the lung lining and cancer tumors. Neither lung is removed in this surgery.

Chemotherapy for Pleural Mesothelioma

Chemotherapy is one of the most common types of treatment for pleural mesothelioma. Most patients can receive a combination of two chemotherapy drugs: cisplatin and pemetrexed.

Chemotherapy may be used by itself or alongside other treatments. For example, doctors use hyperthermic intrathoracic chemotherapy (HITOC) after surgery. This can destroy microscopic mesothelioma cells that surgery couldn’t remove.

Amy Fair
Amy FairRegistered Nurse
20+ years helping mesothelioma victims

"Chemotherapy is, for most people, intravenous. It goes in the vein. It goes through your whole system, [and] it kills your good cells and kills your bad cells."

Learn more about top treatment options with a free veterans packet.

Radiation for Pleural Mesothelioma

Also called radiotherapy, radiation is often used to shrink tumors and ease symptoms of pleural mesothelioma. It may also be used as a follow-up (adjuvant) treatment to kill cancer cells left behind after surgery. However, it’s not used in high doses as the side effects can be toxic.

Types of pleural mesothelioma radiation include:

  • External Beam Radiation Therapy (EBRT): This therapy allows doctors to shrink cancerous tumors without surgery. According to the American Cancer Society (ACS), this is the most common type of mesothelioma radiation therapy.
  • Brachytherapy: With this therapy, a capsule with a radioactive material like iridium is put into the body near cancer tumors. It’s not normally used as a mesothelioma treatment, but it may be available in clinical trials.

Other Pleural Mesothelioma Treatment Options

Immunotherapy for Pleural Mesothelioma

Immunotherapy stimulates the body’s immune system to fight cancer cells more effectively.

In October 2020, the Food and Drug Administration (FDA) approved combining two immunotherapy drugs (Opdivo® and Yervoy®) for pleural mesothelioma patients.

Tumor Treating Fields for Pleural Mesothelioma

Tumor treating fields (TTFs) interrupt the growth of cancer cells using electrical pads that stick to the body.

The OptuneLua®, a TTF device made by Novocure, was approved to treat pleural mesothelioma by the FDA in 2019. Current treatments combine chemotherapy with TTFs.

Get your Free Veterans Packet to learn more about top treatments for mesothelioma.

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  • Treatment Options
  • Mesothelioma Specialists
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Peritoneal Mesothelioma Treatment

Peritoneal mesothelioma forms in the lining of the abdomen (peritoneum). This type of mesothelioma accounts for 10-15% of all cases.

The preferred peritoneal mesothelioma treatment is cytoreduction with HIPEC and combines surgery and chemotherapy.

This treatment has two parts:

  1. Cytoreductive surgery: Doctors remove visible cancerous tumors from the abdominal lining and diseased abdominal lining with this debulking surgery.
  2. Chemotherapy: After surgery, doctors bathe the abdominal cavity with hyperthermic intraperitoneal chemotherapy (HIPEC) — heated cancer-killing drugs.

Other treatments like radiation therapy may also be used in some cases. A doctor can recommend treatments for you based on how far the cancer has spread and other factors.

Treatment of Rare Mesothelioma Types

Mesothelioma can form in the linings of the heart (pericardial mesothelioma) or testicles (testicular mesothelioma) in rare cases. Thankfully, doctors can still treat these rare types.

Treatments for these rare types of mesothelioma include:

  • Pericardiectomy: This is a surgical procedure for pericardial mesothelioma. Mesothelioma inflames the heart lining and can cause the heart to work harder. Doctors remove some or all of the heart lining and cancer tumors to improve heart function.
  • Pericardiocentesis: This treatment is used in cases of late-stage pericardial mesothelioma. This treatment drains fluid from the heart lining using a catheter.
  • Orchiectomy: Used for testicular mesothelioma, this surgery removes one or both of the testicles to prevent cancer spread. Doctors may also perform a partial orchiectomy in some cases, too.

Clinical Trials & Mesothelioma Treatments

More mesothelioma cancer treatments are now becoming available thanks to clinical trials. These trials are a form of cancer research as they test new treatments to see how effective they are. Past mesothelioma clinical trials led to new treatments like immunotherapy and TTFs.

Clinical trials currently test new treatments like:

  • Photodynamic Therapy: This treatment uses light to kill cancer cells with a light-sensitive medicine. It may also be used with other mesothelioma treatments like surgery.
  • Cryotherapy: An extremely cold liquid or spray is used to shrink cancer tumors.
  • Gene Therapy: Doctors can add genes to cancer cells to destroy them more easily, according to the ACS. It can be combined with other treatments like immunotherapy.

Patients who want to join a clinical trial should speak to their cancer care teams. Factors like the type of cancer someone has and how far it’s spread can affect eligibility.

Amy Fair
Amy FairRegistered Nurse
20+ years helping mesothelioma victims

"I encourage clinical trials because they’re free, so you don’t pay for anything. But you’ve got to be a really good candidate, because if you’re very sick, it’s a long process. And sometimes you’re getting a placebo, and sometimes you’re getting the actual drug."

Our qualified nursing staff can help you access mesothelioma clinical trials. Call (877) 450-8973 to get started.

Palliative Mesothelioma Treatments

Not every cancer patient will qualify for life-extending mesothelioma treatments. That said, palliative cancer treatments are still available to help patients manage their symptoms and reduce their pain.

Palliative treatments for mesothelioma include:

  • PleurX Catheter: Pleural mesothelioma patients often have pleural effusions (buildups of fluid within the lung lining). A PleurX catheter allows patients to drain fluid buildup without hospitalization.
  • Pleurodesis: This allows doctors to seal the lung lining to prevent fluid buildup. This can ease symptoms like shortness of breath and prevent the patient from having more pleural effusions.
  • Thoracentesis/Paracentesis: These treatments allow doctors to remove excess fluid from the lining of the lung or abdomen. Doctors insert a thin needle into the site where the fluid has built up and drain it.
  • Minor Surgery: Minor surgeries can be used to reduce the size of tumors and ease symptoms. Unfortunately, these surgeries won’t help patients live longer.

Get a free veterans packet to learn about palliative care options.

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  • Treatment Options
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Alternative Mesothelioma Treatments

Alternative treatments are also available for patients with mesothelioma. They work to reduce stress and bolster general well-being. Patients also report many positive mental and physical health benefits.

Alternative treatments for mesothelioma include:

  • Exercise
  • Herbal therapies
  • Meditation and breathing techniques
  • Well-balanced diet
  • Yoga

Although these methods may ease physical symptoms or stress, alternative treatments are not a substitute for professional medical care. Talk to a doctor to see how alternative therapies can be used alongside standard treatments.

How to Access Treatment for Mesothelioma Cancer

A mesothelioma doctor at a specialized cancer center can help patients get properly diagnosed and treated. It’s crucial to get treatments from a mesothelioma doctor since this cancer is so rare and aggressive.

"It’s the most important thing in the world to go to the best doctor in the world for what you have."
—Dennis, Mesothelioma Patient

Mesothelioma Doctors

Mesothelioma doctors dedicate their time and experience to helping patients with this cancer. Veterans facing a mesothelioma diagnosis should know that the VA works with some of the top mesothelioma doctors in the country.

Our team can connect you with top mesothelioma doctors right now. Find a doctor near you using our locator tool.

Mesothelioma Treatment Centers

Mesothelioma cancer centers have access to cutting-edge treatment options and state-of-the-art equipment. Cancer centers around the country specialize in mesothelioma treatment.

VA mesothelioma cancer centers include:

Affording Mesothelioma Treatment Costs

Patients battling mesothelioma should not have to worry about how they will pay for treatment.

Thankfully, mesothelioma treatment centers often work with a patient’s insurance company to ensure all medical claims and costs are covered. This reduces the stress of dealing with medical costs directly.

Further, veterans and civilians with mesothelioma can pursue financial compensation to help pay for their medical care. Patients can access financial support programs through the VA and other avenues, including asbestos trust funds and legal settlements.

Get a free mesothelioma veterans packet to learn more about your compensation options.

Mesothelioma Treatment: Common Questions

Is mesothelioma always fatal?

No. While there is not yet a cure for this cancer, there have been cases of patients who have entered mesothelioma remission and survived well past their projected life expectancy.

While average mesothelioma survival rates are fairly low, aggressive treatments may help patients live longer.

Are there any new treatments for mesothelioma?

Yes. New treatments for mesothelioma are being tested and researched all the time. They offer hope to patients when standard treatments don’t work.

The best way to access new mesothelioma treatment options is through clinical trials. Clinical trials study new treatments to help patients live longer or to better manage their symptoms. These trials follow strict mesothelioma treatment guidelines to keep patients safe.

What is mesothelioma life expectancy without treatment?

The life expectancy of a mesothelioma patient without treatment is around 4-12 months. This is because mesothelioma is aggressive and can quickly spread to lymph nodes and distant areas of the body.

How can veterans access mesothelioma treatments?

Veterans may be able to get mesothelioma treatments if they have VA Health Care. The VA Health Care program allows veterans to receive free or low-cost treatments from VA doctors.

Veterans can join this health care program when they apply for VA benefits if they’re not automatically enrolled.

Outside of VA Health Care, veterans can also use private health care insurance plans to get mesothelioma treatments from civilian doctors.

Veterans Support Team
Todd Gersten, MD PhotoReviewed by:Todd Gersten, MD

Double Board-Certified Oncologist and Hematologist

  • Fact-Checked
  • Editor

Todd Gersten, MD is a double board-certified medical oncologist and hematologist specializing in general adult oncology and hematologic disease. He is a physician partner with the Florida Cancer Specialists and practices in Wellington, Florida.

Dr. Todd Gersten is an independently paid medical reviewer.

Christopher Dryfoos PhotoWritten by:

Contributing Author

Christopher Dryfoos is a journalist and member of the American Medical Writers Association (AMWA). As the grandson of the U.S. Navy’s first forensic pathologist, he aims to help veterans with mesothelioma access needed care.

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